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Summary: Epidemiological data suggest that influenza vaccination protects against all‐cause mortality in chronic obstructive pulmonary disease (COPD) patients. However, recent work has suggested there is a defect in the ability of some COPD patients to mount an adequate humoral response to influenza vaccination. The aim of our study was to investigate humoral and cell‐mediated vaccine responses to the seasonal trivalent influenza vaccination (TIV) in COPD subjects and healthy controls. Forty‐seven subjects were enrolled into the study; 23 COPD patients, 13 age‐matched healthy controls (HC ≥ 50) and 11 young healthy control subjects (YC ≤ 40). Serum and peripheral blood mononuclear cells (PBMC) were isolated pre‐TIV vaccination and at days 7 and 28 and 6 months post‐vaccine for haemagglutinin inhibition (HAI) titre, antigen‐specific T cell and antibody‐secreting cell analysis. The kinetics of the vaccine response were similar between YC, HC and COPD patients and there was no significant difference in antibody titres between these groups at 28 days post‐vaccine. As we observed no disease‐dependent differences in either humoral or cellular responses, we investigated if there was any association of these measures with age. H1N1 (r = −0·4253, P = 0·0036) and influenza B (r = −0·344, P = 0·0192) antibody titre at 28 days negatively correlated with age, as did H1N1‐specific CD4+ T helper cells (r = −0·4276, P = 0·0034). These results suggest that age is the primary determinant of response to trivalent vaccine and that COPD is not a driver of deficient responses per se. These data support the continued use of the yearly trivalent vaccine as an adjunct to COPD disease management. [ABSTRACT FROM AUTHOR]

Nicholas P Williams,1,2 Ngaire A Coombs,3 Matthew J Johnson,4 Lynn K Josephs,3,4 Lucy A Rigge,2,4 Karl J Staples,2 Mike Thomas,1,3,4 Tom MA Wilkinson1,2,4 1Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, 2Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, 3Primary Care and Population Sciences, Faculty of Medicine, Southampton General Hospital, 4NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton, UK Background: Community-acquired pneumonia (CAP) is more common in patients with COPD than in the adult general population, with studies of hospitalized CAP patients consistently reporting COPD as a frequent comorbidity. However, despite an increasing recognition of its importance, large studies evaluating the incidence patterns over time, risk factors and burden of CAP in COPD are currently lacking.Methods: A retrospective observational study using a large UK-based database of linked primary and secondary care records was conducted. Patients with a diagnosis of COPD aged ≥40 years were followed up for 5 years from January 1, 2010. CAP and exacerbation episodes were identified from hospital discharge data and primary care coding records, and rates were calculated per month, adjusting for mortality, and displayed over time. In addition, baseline factors predicting future risk of CAP and hospital admission with CAP were identified.Results: A total of 14,513 COPD patients were identified: 13.4% (n=1,938) had ≥1 CAP episode, of whom 18.8% suffered from recurrent (≥2) CAP. Highest rates of both CAP and exacerbations were seen in winter. A greater proportion of frequent, compared to infrequent, exacerbators experienced recurrent CAP (5.1% versus 2.0%, respectively, P